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Allergy Sufferers Unite – The Facts Behind Your Fears

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Do you feel like your allergies are driving you crazy? Do you find yourself congested, coughing, and sneezing for what seems to be forever? If you’ve ever had a sneezing fit in the middle of a dusty room or felt your chest constrict after petting a fluffy cat, you know the discomfort of allergies. If so, you’re probably wondering how this is different from asthma. To help answer these questions (and many more), we’ll delve into the world of allergies and asthma to better understand the differences between them – and how to most effectively treat each condition.

While both allergy & asthma often come with breathing difficulties, they have different underlying causes. Allergies stem from your immune system’s overreaction to usually harmless substances like pollen or pet dander. Asthma, on the other hand, occurs when your airways become inflamed and narrow, making it hard to breathe. In short, allergies make you feel like you’re drowning in snot, while asthma makes you feel like you’re slowly suffocating. Fun stuff, huh?

So what exactly are the symptoms of allergy?

  1. Sneezing and itching usually have to be present in order for you to be tested for allergy. Remember, the molecule responsible for your immune system’s overreaction is called IgE and literally looks like a “Y”. Skin testing and blood work both detect this IgE molecule and confirm that you indeed have allergies.
  2. And why should you care if you have allergies or not? It’s very easy to confuse a runny nose or congestion due to sinus infections with allergies. Treating sinus infections with allergy shots, for instance, won’t improve your symptoms. More on treatment of sinus infections later. The bottom line is it matters making the correct diagnosis for your sneezing or runny nose. Similarly, if you have allergies and are treated with antibiotics only, you’ll probably keep on sneezing.

Gimme some treatments for allergies and we’ll see how to get the right one!

  1. Once you know what allergies you have, avoid what bothers you! This may not be as easy as it looks. How many of you have pets that you can’t get rid of? Keep in mind that avoidance of pet dander includes exposure at work & school, not just at home. Mold is a very common allergen that can be avoided by decreasing your indoor humidity. You can measure you humidity by using a hygrometer and ideally, the indoor humidity should be between 30-50%. Too high and mold growth will get out of hand. Finally, don’t forget to cover your mattress and pillows with a dust mite impermeable covering. These coverings don’t crinkle like they used to and you can actually get a comfortable sleep (and your partner).
  2. Medication compounds are often very similar for both asthma and allergies, it only depends WHERE the medication is delivered. (of course the nose for allergies and the lungs for asthma). In years past, we relied on inhaled corticosteroids as the “gold standard” for both allergic rhinitis and asthma. Times have changed with the new definition of eosinophilic asthma, and the use of biologicals for asthma have been a game-changer for coughing and wheezing that doesn’t respond to inhaled medication.
  3. Allergy shots, also known as allergen immunotherapy, have been used for many years to treat patients with allergic rhinitis and asthma. The treatment involves gradually exposing the patient to increasing doses of an allergen, such as pollen or dust mites, in order to desensitize the immune system and reduce the severity of allergic reactions. Research has shown that allergy shots can be a highly effective treatment for these conditions, with some studies reporting symptom improvement in up to 85% of patients. In addition to relieving symptoms, allergy shots may also decrease the need for medication and reduce the risk of developing asthma in patients with allergic rhinitis, particularly when starting shots during childhood. While the use of allergy shots requires careful monitoring and a significant time commitment, it has the potential to provide long-lasting relief for those suffering from these common allergic conditions.

So how does asthma really differ from allergies?

Asthma affects the lungs and causes difficulty breathing, while allergies affect the nose causing sneezing, congestion, itchy eyes when exposed to specific triggers (like pollen, dust mites, or food).

  • Allergies don’t only affect the nose however, and this is the source of much confusion between allergies and asthma.
  • Allergies will often trigger inflammation in the lungs, leading to allergen-induced asthma. This spring season, many allergy sufferers will report wheezing and difficulty breathing because of this inflammation. You treat the allergies and the asthma symptoms may go away.
  • But allergies aren’t the only trigger for asthma. Consider cold air, viral infections, perfumes, and eosinophilia. Triggers are anything that induces inflammation in the lungs and will usually make you wheeze, cough, or experience shortness of breath.
  • There’s an app for that! Just to illustrate the connection between allergies and asthma, I pulled an article on smartphone applications for both conditions. You treat one, and often times you’ll treat the other without really knowing it.

Kagen S, Garland A. Asthma and Allergy Mobile Apps in 2018. Curr Allergy Asthma Rep. 2019 Feb 2;19(1):6. doi: 10.1007/s11882-019-0840-z. PMID: 30712150; PMCID: PMC6394463. (and most importantly, this article is free on-line)

Purpose of review: This paper offers a comprehensive review of interactive mobile allergy and asthma smartphone applications available within the USA in 2018, with an emphasis on interactive asthma apps.

Recent findings: Primary care and specialty clinicians interested in introducing digital health apps into their practices will soon have more choices, for Apple® and major electronic medical record software companies are investing heavily in the mobile medical marketplace, guaranteeing personal health information and access to care will always be immediately available in one’s digital hand. Interactive mobile asthma applications are valuable assets for patients and caregivers alike, for they offer immediate communications between patients and those responsible for providing for their needs.

Keywords: Allergy; App; Asthma; Digital health; Mobile application; Outcome measures; Peak expiratory flow; Smartphone; Symptom score test; mHealth.

So why is it so important to distinguish between allergies and asthma? Treatment of asthma is actually quite different than allergies and if you miss the diagnosis, patients will miss some very important medications specific for asthma.

  • Patients generally don’t like the diagnosis of asthma because of the stigma associated with this condition for the past 30 years. Before effective medications for asthma, patients were left with poor quality of life and bad health insurance quotes because of the underlying disease. And the first question I’m asked after prescribing an inhaler for asthma? Doc, when can I stop this medication?
  • You can’t treat what you don’t diagnose. Go ahead, if you have asthma, your outlook is much better now than in the past. For instance, your chances of winning a medal in the Olympics is now just as good if you have asthma compared to those athletes that don’t.
  • Biologicals have now allowed asthma patients more freedom and better compliance by using controller therapy 1-2 times a month, rather than inhalers every 4-6 hours every day. Look at the link on biologicals and you’ll see some videos of very happy asthma patients.

So next time you’re feeling the pollen season, take a closer look and figure out what’s really going on – and save the inhaler for when it’s actually needed!

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